Search PubMed⌕ Search

Biomedical subjects

R H Ossoff

Publications and source records attributed to R H Ossoff.

At least 109 records · Page 6Linked to original sources
PubMed1984

A new laser-laryngoscope coupler.

A new generation of laser surgery of the larynx is possible with this laser-laryngoscopic coupler. The applications are numerous. The surgeon can custom-tailor his working environment rather than stretching himself to the demands of the equipment and can adjust the laser to meet the surgical needs of the patient's disease. No longer must large quantities of tissue be ablated. Fine incisions can be made, pathologic margins can be more clearly examined, and smaller lesions can be treated and biopsied with increased tissue conservation and precision.

Laryngoscopes↗
PubMed1984

Use of dextran and post-primary antibody fixation in immunoperoxidase staining of fresh frozen tissue. Detection of immunoglobulin associated with squamous carcinomas of the head and neck.

Use of unfixed fresh frozen tissue sections for immunocytochemical studies reduces the possibility of denaturation of antigenic determinants compared to formalin fixation and paraffin embedding procedures. However, tissue and cellular morphology can be extensively altered in the numerous application and washing steps with frozen tissue sections. We tested a number of buffer solutions and showed that the use of dextran-containing buffers and fixation by glutaraldehyde after primary antibody application preserves tissue morphology. The procedures described here are also applicable to ascertaining the presence of Fc receptors of leukocytes in sections of carcinoma tissues. The buffered dextran washes and post-primary antibody fixation method was used to demonstrate the presence of immunoglobulin associated with squamous carcinoma cells. The immunoglobulin was not removed by washing of tissue sections at 37 degrees C but could be removed by low or high pH buffer washes, suggesting that the immunoglobulin is bound in a specific manner.

Antibodies, Neoplasm↗
PubMed1984

Endoscopic laser arytenoidectomy for the treatment of bilateral vocal cord paralysis.

Most patients with bilateral vocal cord paralysis have a fairly satisfactory voice, but their airway is usually compromised. The management of such patients presents a challenge to the otolaryngologist-head and neck surgeon. Numerous surgical procedures have been developed in an attempt to improve the patients's airway insufficiency without leaving him with a breathy, weak voice. Arytenoidectomy is currently the most reliable method of treating patients with bilateral vocal cord paralysis. Although both endoscopic and external approaches have been described for performing an arytenoidectomy, the endoscopic technique is more desirable since it requires no incision and theoretically allows for the immediate assessment of airway size. The addition of the CO2 laser to the surgical armamentarium offers certain refinements to the technique of endoscopic arytenoidectomy. Eleven patients with bilateral vocal cord paralysis of the larynx have been treated by endoscopic laser arytenoidectomy by the authors utilizing a technique developed by the two senior authors and subsequently taught to over 200 participants of the CO2 laser workshops sponsored by the Department of Otolaryngology-Head and Neck Surgery at Northwestern University Medical School; 10 of the 11 patients have been successfully decannulated. The technique and problems of this operation will be discussed.

Aged↗
PubMed1983

Carcinoma of the tongue in persons younger than 30 years of age.

Squamous cell carcinoma of the tongue in young people is a rare disease. The usual causal agents associated with this disease in older patients may not be operative in this younger age group or may involve a greatly reduced latency. Failure to perform a biopsy of tongue lesions in young patients often leads to late diagnosis. The prognosis is similar, stage for stage, as for older patients. Thirteen cases of squamous cell carcinoma of the tongue occurred in patients younger than 30 years of age. Their clinical appearance, stage and histologic state, treatment, and survival are discussed. A high index of suspicion leading to early diagnosis and systematic adequate treatment are needed to alter the unfavorable prognosis of this lesion.

Adolescent↗
PubMed1983

Complications after pectoralis major myocutaneous flap reconstruction of head and neck defects.

This article reviews our experience with 86 patients undergoing 95 pectoralis major myocutaneous flap reconstructions. Complications and their incidence were very similar to those reported in previous series. Three cases of hidden recurrences appear to be previously unreported complications. The problem of delayed detection of recurrence in at-risk patients is an important one and may be unique to myocutaneous flaps. With the exception of the problem of hidden recurrence, the pectoralis major myocutaneous flap compares favorably with other methods of reconstruction of head and neck defects. Its size, viability, and versatility make it a valuable tool for extending the limits of resectability and reconstruction.

Fistula↗
PubMed1983

CO2 laser in otolaryngology-head and neck surgery: a retrospective analysis of complications.

A retrospective review was conducted of all patients undergoing CO2 laser surgery by members of the Department of Otolaryngology-Head and Neck Surgery at Northwestern University Medical School from January 1, 1980 through December 31, 1981; 204 cases were identified and all are included in this report. Early in our department's experience with laser surgery, an endotracheal tube fire occurred. This incident precipitated a departmental review of complications associated with the use of the CO2 laser and resulted in the formulation of a laser safety protocol. All patients in this group were treated under the directives of this protocol; the operative complication rate was low. This retrospective analysis of complications associated with the use of the CO2 laser under a strictly applied protocol demonstrates the relative safety associated with judicious use of this instrument.

Equipment Safety↗
PubMed1983

Endoscopic laser arytenoidectomy.

Most patients with bilateral vocal cord paralysis have a fairly satisfactory voice, but their airway is usually inadequate for day-to-day exertion. In some patients, the airway may be inadequate for even quiet respiration and an indwelling tracheotomy is required. Solution to this problem has involved the following techniques: tracheotomy, lateralization of the vocal cord by either endoscopic or external routes, or vocal cord reinnervation by the nerve-muscle transposition technique. Endoscopic laser arytenoidectomy has been mentioned in the literature. However, the actual technique as well as the attendant morbidity associated with this procedure has not been highlighted. Four patients with bilateral vocal cord paralysis of the larynx have been treated by endoscopic laser arytenoidectomy at Northwestern University Medical School. The technique, problems, and results are discussed.

Aged↗
PubMed1982

A compendium of intranasal flaps.

The reconstructive surgeon is frequently called upon to repair intranasal defects which require the use of grafts and/or flaps. In general, flaps are difficult to design and utilize because of 1. limited intranasal exposure and 2. the complex design requirements for movement of the flap through three dimensions. Intranasal exposure is increased by the transoral premaxillary approach, the lateral alotomy, the lateral rhinotomy, the transethmoid, and the open rhinoplasty. The flaps to be designed all utilize the basic principles for skin flaps. However in contrast to movement on a relatively two-dimensional surface, they frequently require movement in the three dimensions, i.e., from the floor of the nose up to the septum, from the side to the center, etc. We review the following flaps: 1. mucoperichondrial advancement and rotation flaps of the septum, 2. composite septal flap, 3. inferior turbinate flaps, 4. nasal floor mucoperiosteal flaps, 5. middle turbinate flaps, 6. composite lateral cartilage flaps, 7. buccal sulcus flaps, and 8. nasolabial flaps.

Adult↗
PubMed1981

Immediate reconstruction of mandibular defects with a composite sternocleidomastoid musculoclavicular graft.

The problem of mandibular reconstruction has been approached using many surgical techniques. This article studies one such approach--reconstruction using full-thickness clavicle pedicled on the sternocleidomastoid muscle. Five patients with stage II and stage III carcinoma of the anterior part of the floor of the mouth were treated with mandibular resection and neck dissection. The resulting defects were immediately reconstructed with the clavicle-sternocleidomastoid muscle technique. The patients were observed from one to three years and were examined postoperatively with technetium Tc 99m medronate scans, which demonstrated the grafts to be viable. The technique proved reliable in a limited clinical trial.

Carcinoma↗
PubMed1981

Lymphatics of the floor of the mouth and neck: anatomical studies related to contralateral drainage pathways.

An anatomical study was made to determine the role of the regional lymphatic drainage pathways in contralateral flow from the floor of the mouth in the dog. Microsurgical techniques were used to cannulate and perfuse a lymphatic vessel. Following a two hour infusion, bilateral radical neck dissections were performed. An efferent upper jugular communicating pathway was repeatedly identified which crossed the midline and drained into the contralateral subdigastric group of nodes. These studies demonstrate a precise role for the regional lymphatic drainage pathways in contralateral flow from the floor of the mouth.

Animals↗
PubMed1980

Acute epiglottitis in adults.

Epiglottitis occurs more often in adults than is generally recognized. Six adults with epiglottitis were treated at Evanston (III) Hospital from March to August 1978. Two required tracheostomy because of delayed diagnosis. There were no deaths. This experience suggests that any patient with acute, painful dysphagia should have indirect laryngoscopy or a carefully interpreted lateral roentgenogram to the neck to rule out epiglottitis.

Acute Disease↗
PubMed1980

Acute infectious supraglottitis in adults.

We report two cases of acute infectious supraglottitis in adults seen recently in our emergency department. The recent literature appropriate to the diagnosis and treatment of the entity is reviewed. In each of our cases the diagnosis was established with indirect laryngoscopy in the emergency department and appropriate therapy instituted without delay. Supraglottitis in adults is increasing in prevalence and emergency physicians must be familiar with the diagnosis and early management of such patients.

Acute Disease↗
PubMed1980

Acute epiglottitis in adults: experience with fifteen cases.

Fifteen adults with acute epiglottitis are discussed. Three required tracheostomy because of delayed diagnosis. There were no deaths. Epiglottitis occurs more often in adults than is generally recognized. The early symptoms of epiglottitis in adults are sore throat and dysphagia. Any patient with acute, painful dysphagia should have indirect laryngoscopy to rule out epiglottitis. Throat and blood cultures were obtained from 14 of our cases. Cultures from only two patients were positive for Hemophilus influenzae, type B; cultures from the other 12 patients did not grow any bacterial pathogens. The primary treatment of adult epiglottitis is intravenous steroids, antibiotics, and humidified oxygen. Observation by the managing physician is mandatory during the first four hours of treatment. Tracheostomy is indicated in progressive disease.

Acute Disease↗
PubMed1979

Histopathology of congenital subglottic stenosis.

Three patients with congenital subglottic stenosis are presented and whole organ serial-section studies of their larynges are discussed. A superiorly displaced first tracheal ring is observed to form a cartilaginous subglottic stenosis in one. This "trapped first ring" is demonstrated in horizontal, sagittal and coronal planes. Subglottic stenosis is a clinical diagnosis which describes multifarious histopathological forms of narrowing within the subglottic larynx.

Cricoid Cartilage↗